This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (45)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Resolving the Controversy

Marc R. Mayberg, MD; H. Richard Winn, MD

JAMA. 1995;273(18):1459-1461.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Since its inception in the 1950s, carotid endarterectomy has been widely applied as a means to prevent cerebral infarction. The removal of stenotic or ulcerated lesions at the cervical carotid bifurcation appeared to be a logical and practical approach to stroke prevention. However, the appropriateness of this operation became a matter of controversy in the mid 1980s,^1,2 in part because of the lack of objective data demonstrating the efficacy of carotid endarterectomy in preventing stroke. Subsequent to that time, six prospective, randomized trials for endarterectomy have been reported,^3-8 five of which have shown benefit for surgery in preventing cerebral ischemia.

Three trials^4-6 randomized patients with symptomatic carotid stenosis (ie, transient ischemic attack, amaurosis fugax, or small completed stroke ipsilateral to the carotid narrowing). Several notable features were common to all three trials of symptomatic carotid stenosis. First, carotid endarterectomy provided significant protection against subsequent ipsilateral stroke in . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Neurological Surgery, University of Washington, Seattle.

Footnotes
Reprint requests to Department of Neurological Surgery, University of Washington, Mail Stop RI-20, Seattle, WA 98195 (Dr Mayberg).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?